Results Summary

What was the research about?

Senior living facilities and community centers often hold exercise classes for older adults. Exercise can help older adults improve walking ability. Improving walking ability can help older adults avoid falls and continue to live on their own. The research team wanted to see how a standard group exercise class compared with a new class called On the Move to improve walking ability.  

The focus of the exercises in the On the Move class was improving walking ability. In the On the Move class, people exercised while standing up for the entire class. In the standard exercise class, people exercised while sitting down. Both classes included a warm-up, a cooldown, and gentle exercises and stretches for the whole body.

The research team also wanted to see if it mattered who taught the exercise classes. The team compared classes taught by professional exercise teachers with classes taught by trained staff at the senior centers.

What were the results?

People in the On the Move class showed greater improvement in their walking ability than those in the standard exercise class. The On the Move and standard exercise classes worked about the same in helping older adults continue living on their own.

People improved their walking ability more when exercise teachers taught the classes than when trained center staff did. When trained center staff taught the classes, the On the Move class didn’t improve people’s walking ability more than the standard exercise class did.

Who was in the study?

This study included 424 adults ages 65 or older. Some people lived in senior living facilities. Others lived in their own homes and went to senior community centers. The average age was 81. Some people had trouble walking but all could walk on their own, with or without a cane.

What did the research team do?

The study included 32 senior living facilities and community centers. The research team assigned 16 of the centers to offer the On the Move class, and the other 16 to offer the standard group exercise class. There were 201 people who took the On the Move class and 223 people who took the standard group exercise class. Each class had 10 or fewer people. Both types of classes met for 50 minutes, twice a week, for 12 weeks.

The research team checked each person’s ability to walk and move around before the study began and after taking 12 weeks of classes. The team asked people to fill out a survey and gave them two walking tests. The team used the surveys and tests to see which class helped people improve their walking ability more. The team also checked if results were the same depending on who taught the class.

What were the limits of the study?

The research team had trouble finding staff at the senior living and community centers to teach the classes. Also, fewer people finished the full 12 weeks of group exercise classes when taught by trained center staff compared with classes taught by exercise teachers. This difference could have occurred because the adults didn’t like the class, or there may have been some other reason. Lastly, the study took place in Pittsburgh, Pennsylvania. Results may be different for older adults living in other places.

Future research could look at how to help senior center staff teach group exercise classes so that those classes get the same results as ones taught by trained exercise teachers.

How can people use the results?

Senior living facilities and community centers can use these results when deciding what type of exercise classes to offer older adults to help them keep walking. 

Final Research Report

View this project's final research report.

Peer-Review Summary

Peer review of PCORI-funded research helps make sure the report presents complete, balanced, and useful information about the research. It also assesses how the project addressed PCORI’s Methodology Standards. During peer review, experts read a draft report of the research and provide comments about the report. These experts may include a scientist focused on the research topic, a specialist in research methods, a patient or caregiver, and a healthcare professional. These reviewers cannot have conflicts of interest with the study.

The peer reviewers point out where the draft report may need revision. For example, they may suggest ways to improve descriptions of the conduct of the study or to clarify the connection between results and conclusions. Sometimes, awardees revise their draft reports twice or more to address all of the reviewers’ comments. 

The awardee made the following revisions in response to peer review:

  • The awardee revised the explanation of randomization by emphasizing that it was impossible to randomly assign participants to exercise leaders because some facilities had too few leaders. Consequently, the resulting comparisons of outcomes for patients receiving the intervention from exercise leaders or facility staff should be considered exploratory and interpreted with caution.
  • The awardee explained their choice of the standard intervention as the comparator to On the Move. The standard intervention did not have a walking or weight-bearing component, but the awardee stated this was typical for interventions usually offered at study sites.
  • The awardee emphasized the exploratory nature of the heterogeneity of treatment effects (HTE) analyses, because they were not prespecified. The awardee indicated that readers should consider the findings tentative.
  • The awardee provided more information about strengths and limitations of the study sample. The awardee addressed reviewers’ concerns about the homogeneity of the study population by commenting that although the sample had limited racial and ethnic diversity, participants’ living arrangements were diverse. The investigators also noted the exclusion from the study of patients with significant movement and sensory disabilities, or who needed assistive devices.

Conflict of Interest Disclosures

Project Information

Jennifer S. Brach, PhD
University of Pittsburgh at Pittsburgh
$1,847,399
10.25302/3.2018.CE.13046301
On the Move: Optimizing Participation in Group Exercise to Prevent Walking Difficulty in At-Risk Older Adults

Key Dates

September 2013
June 2017
2013
2017

Study Registration Information

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Last updated: April 19, 2024